Book Review - The Making of a Tropical Disease - A Short History of Malaria by Randall M. Packard
Through the Amazon Vine review program, I received a copy of the book The Making of a Tropical Disease: A Short History of Malaria by Randall M. Packard. The book wasn't quite what I was expecting. I imagined something along the lines of a historical narrative following people and events over a period of time. Instead, it's more of a medical and social essay on the disease, conditions that led to its spread and migration, and efforts that have been taken (and often failed) to eradicate it. But even though I came into the book with faulty expectations, Making still does a good job at what it sets out to accomplish.
Mulanda; Constructing a Global Narrative; Beginnings; Malaria Moves North; A Southern Disease; Tropical Development and Malaria; The Making of a Vector-Borne Disease; Malaria Dreams; Malaria Realities; Rolling Back Malaria - The Future of a Tropical Disease?; Ecology and Policy; Acknowledgments; Notes; Index
I think the typical layman views malaria as a disease that primarily exists in the jungles of South America and the plains of Africa. But in reality, malaria has over the years visited just about every part of the globe. Packard goes back centuries to trace the disease and follow the migration paths that it has taken. He goes into deep medical detail on how the virus infects humans, is spread to mosquitos, and then is transmitted back to humans by the mosquitos. The critical factor is the breeding areas for the insects, which is normally stagnant pools of standing water. If left to its own ways, nature would control the situation pretty well. But "civilization" often comes in, creates artificial areas which collect water, and offer up a human population that has little resistance to malaria. A prime example is the tens of thousands of deaths that occurred during the building of the Panama Canal, as all the construction changed the drainage patterns, leading to prime breeding grounds for insects. Even during our own history in America, wide areas of the South were regularly endemic with malaria. But through environmental control and management, many of the breeding areas for mosquitos have been treated to prevent outbreaks. That doesn't mean the disease doesn't happen any more in America. It just means it's much more rare.
The more devastating information is when the author looks at how malaria keeps entire countries in Africa mired in poverty. The money available to fight the disease isn't nearly enough, and even concentrated programs to eliminate malaria don't have lasting effects. Either the programs aren't maintained and the conditions return, or people don't change behaviors that cause the spread of the disease. I think what struck me most is that nearly every attempt by man to "improve" something has unintended and unforeseen side effects that are often more costly than the initial benefit. Even the simple act of people migrating to new areas can bring disease to areas not equipped to deal with it. We're really not as smart as we think we are, nor have we learned much along the way.
While I wouldn't recommend this book to a casual reader, I would say that it's a good read for someone who has a medical background and is looking for a scholarly examination of how a particular condition can have wide-ranging ramifications on society both in the short and long term.